[The nurse's work in mental health services of the public network of Campinas-SP].
This work aimed at verifying the field of performance of nurses in the mental health services in the city of Campinas-SP as well as at analyzing their work relations with other members of the multi-professional staff as an attempt to observe the nexuses established between such professionals' practice and the service's conception concerning team work. A qualitative and descriptive investigation was conducted which used the case report as a research methodology. It was observed that nurses take different roles according to the organization of the team's work process and that the recognition of such context is essential for nursing professionals to develop their work critically and to keep high quality standards.


Lymphocyte-specific protein 1 inhibits the growth of hepatocellular carcinoma by suppressing ERK1/2 phosphorylation.
Lymphocyte-specific protein 1 (LSP1) has been reported to regulate cell biology in several human cancers including lymphoma and breast cancer. However, the functions of LSP1 in human hepatocellular carcinoma (HCC) are still unknown. In this study, we found that LSP1 expression was downregulated in HCC tissues and cell lines, and lower LSP1 expression was correlated with poor clinicopathological features including large tumor size, high Edmondson-Steiner grading and advanced tumor-node-metastasis (TNM) stage. Additionally, we demonstrated that patients with high LSP1 expression had significantly better overall survival and disease-free survival. Moreover, LSP1 was found to be an independent factor for predicting the prognosis of HCC patients. In vitro and in vivo assays showed that overexpressing LSP1 inhibited HCC growth by inducing both apoptosis and growth arrest. Mechanistically, we found that expression of phosphorylated extracellular regulated protein kinases 1 and 2 (ERK1/2) was downregulated after LSP1 overexpression, indicating LSP1 could suppress HCC growth by inhibiting the ERK pathway in HCC cells. Taken together, these results indicate that LSP1 may serve as a prognostic marker and a potential therapeutic target in human HCC.


Gefitinib enhances sensitivity of endometrial cancer cells to progestin therapy via dual-specificity phosphatase 1.
In this study, we investigated if Gefitinib, an epidermal growth factor receptor (EGFR) inhibitor, augments endometrial cancer (EC) therapy with medroxyprogesterone acetate (MPA). Combined treatment with Gefitinib plus MPA decreased the proliferation and invasiveness of the Ishikawa and RL952 EC cell lines more effectively than MPA treatment alone. Moreover, combined treatment with Gefitinib plus MPA reduced growth of EC xenografts in Balb/c nude mice more than either Gefitinib or MPA alone. The therapeutic efficacy of combined Gefitinib plus MPA treatment was dependent on expression of dual-specificity phosphatase 1 (DUSP1). DUSP1 knockdown in Ishikawa cells treated with Gefitinib plus MPA showed greater proliferation and invasiveness than parental Ishikawa cells treated similarly. EC cells treated with the combination of Gefitinib plus MPA also showed DUSP1-dependent reductions in phospho-ERK1/2 and increases in E-Cadherin. Thus, Gefitinib appears to DUSP1-dependently enhance the therapeutic efficacy of progestin in EC cells.


The CREB-binding protein affects the circadian regulation of behaviour.
Rhythmic changes in light and temperature conditions form the primary environmental cues that synchronize the molecular circadian clock of most species with the external cycles of day and night. Previous studies established a role for the CREB-binding protein (CBP) in molecular clock function by coactivation of circadian transcription. Here, we report that moderately increased levels of CBP strongly dampen circadian behavioural rhythms without affecting molecular oscillations of circadian transcription. Interestingly, light-dark cycles as well as high temperature facilitated a circadian control of behavioural activity. Based on these observations we propose that in addition to its coactivator function for circadian transcription, CBP is involved in the regulation of circadian behaviour down-stream of the circadian clock.


Monoclonal antibodies specific for a conformationally altered state of fibrinogen.
Four monoclonal antibodies were selected by their ability to discriminate surface-bound from soluble fibrinogen. These antibodies reacted with insolubilized fibrinogen but not other immobilized proteins and their reaction with surface-bound fibrinogen was not diminished by a 100-fold excess of soluble fibrinogen. The antibodies reacted with the same or spatially proximal epitopes, and the recognized epitope(s) resided within the gamma chain segment of the D domain of fibrinogen. Fab fragments of the antibodies inhibited fibrin polymerization in a dose dependent manner, suggesting that the epitope(s) was also exposed by the conversion of fibrinogen to fibrin. These data indicate that adsorption of fibrinogen onto a surface induces conformational changes and that similar changes are also evoked when fibrinogen is converted into fibrin.


Middle lobe syndrome: an intriguing presentation of tracheobronchial amyloidosis.
Pulmonary involvement in amyloidosis is a distinct rarity. This clinical entity usually presents as tracheobronchial amyloidosis (TBA). A 32-year-old, never-smoker man presented with episodic dyspnoea and wheezing along with cough and mucoid sputum. The chest radiograph was suggestive of a middle lobe syndrome (MLS). High-resolution CT (HRCT) of the chest confirmed the presence of MLS. In addition, HRCT showed circumferential thickening of the trachea and the main bronchi, with thickening of the posterior membranous wall of trachea. Fibrebronchoscopy, done to evaluate MLS, visualised multiple small polypoidal lesions in the lower part of trachea and carina. Endobronchial biopsies showed homogeneous, acellular amorphous deposit in the subepithelial region, which was congophilic in nature. A diagnosis of TBA presenting as MLS was made. To the best of our knowledge, this is the first detailed report of MLS as a presentation of TBA in the English literature.


[The effects of a high placed jugular bulb on middle ear ventilation (author's transl)].
A study of healthy and inflammed mucosal folds within the middle ear has demonstrated another although narrow airway across the tympanic cavity to the aditus and antrum. The anatomical anomaly of a high placed jugular bulb can interfere not only with ventilation and drainage of mesotypanum but also of the epitympanum and antrum.


Elevated Squamous Cell Carcinoma Antigen, Cytokeratin 19 Fragment, and Carcinoembryonic Antigen Levels in Diabetic Nephropathy.
We aimed to explore whether squamous cell carcinoma antigen (SCC), cytokeratin 19 fragment (Cyfra21-1), neuron-specific enolase (NSE), and carcinoembryonic antigen (CEA) are elevated in diabetic nephropathy (DN) and the association between urinary albumin-to-creatinine ratio (UACR) and tumor markers in diabetic patients. Nondialysis patients with diabetes (n = 261) and 90 healthy controls were enrolled. DN was defined as an UACR ≥ 30 mg/g in the absence of a urinary tract infection or other renal abnormalities. Patients with DN had significantly higher serum SCC, Cyfra21-1, and CEA levels than those with normoalbuminuria and healthy controls. The rates of positive SCC, Cyfra21-1, and CEA significantly increased with increasing urinary albumin excretion (all P for trend < 0.001). In contrast, NSE was not affected by DN. SCC, Cyfra21-1, and CEA were significantly and positively correlated with UACR. In logistic regression, after multivariable adjustment, increased UACR was associated with increased odds ratio of elevated tumor marker levels (all P for trend < 0.05). Serum levels of SCC, Cyfra21-1, and CEA are markedly increased with increasing urinary albumin excretion, which affects the specificity for diagnosis for lung cancer. Appropriate interpretation of tumor markers in diabetic patients is mandatory to avoid unnecessary and even hazardous biopsies.


Hormone-dependent transactivation by the human androgen receptor is regulated by a dnaJ protein.
Genetic studies were performed to examine the role of eukaryotic dnaJ protein, Ydj1p, in the regulated activation of human androgen receptor (hAR) after heterologous expression in Saccharomyces cerevisiae. Hormone-dependent activation of hAR was measured as a function of lacZ reporter gene expression, which was defective in ydj1-151 and ydj1-2 delta null mutant strains compared to the wild type. This defect was not due to receptor misfolding, since hAR in both wild type and mutant strains had a similar capacity to bind hormone. The target for Ydj1p action was determined to be the hAR hormone binding domain since an N-terminal fragment lacking this region was constitutively active in both wild type and ydj1-151 mutant strains. These data correlate hormone dependence of hAR activation with a requirement for Ydj1p function and are consistent with a role for dnaJ proteins in signal transduction by steroid hormone receptors.


Cellular transcription factors enhance herpes simplex virus type 1 oriS-dependent DNA replication.
The herpes simplex virus type 1 (HSV-1) origin of DNA replication, oriS, contains three binding sites for the viral origin binding protein (OBP) flanked by transcriptional regulatory elements of the immediate-early genes encoding ICP4 and ICP22/47. To assess the role of flanking sequences in oriS function, plasmids containing oriS and either wild-type or mutant flanking sequences were tested in transient DNA replication assays. Although the ICP4 and ICP22/47 regulatory regions were shown to enhance oriS function, most individual elements in these regions, including the VP16-responsive TAATGARAT elements, were found to be dispensable for oriS function. In contrast, two oriS core-adjacent regulatory (Oscar) elements, OscarL and OscarR, at the base of the oriS palindrome were shown to enhance oriS function significantly and additively. Specifically, mutational disruption of either element reduced oriS-dependent DNA replication by 60 to 70%, and disruption of both elements reduced replication by 90%. The properties of protein-DNA complexes formed in gel mobility shift assays using uninfected and HSV-1-infected Vero cell nuclear extracts demonstrated that both OscarL and OscarR are binding sites for cellular proteins. Whereas OscarR does not correspond to the consensus binding site of any known transcription factor, OscarL contains a consensus binding site for the transcription factor Sp1. Gel mobility shift and supershift experiments using antibodies directed against members of the Sp1 family of transcription factors demonstrated the presence of Sp1 and Sp3, but not Sp2 or Sp4, in the protein-DNA complexes formed at OscarL. The abilities of OscarL and OscarR to bind their respective cellular proteins correlated directly with the efficiency of oriS-dependent DNA replication. Cooperative interactions between the Oscar-binding factors and proteins binding to adjacent OBP binding sites were not observed. Notably, Oscar element mutations that impaired oriS-dependent DNA replication had no detectable effect on either basal or induced levels of transcription from the ICP4 and ICP22/47 promoters, as determined by RNase protection assays. The Oscar elements thus appear to provide binding sites for cellular proteins that facilitate oriS-dependent DNA replication but have no effect on transcription of oriS-flanking genes.


Obesity and anesthetic pharmacology: simulation of target-controlled infusion models of propofol and remifentanil.
The prevalence of obesity is increasing, resulting in an increase in the number of surgeries performed to treat obesity and diseases induced by obesity. The associated comorbidities as well as the pharmacokinetic and pharmacodynamic changes that occur in obese patients make it difficult to control the appropriate dose of anesthetic agents. Factors that affect pharmacokinetic changes include the increase in adipose tissue, lean body weight, extracellular fluid, and cardiac output associated with obesity. These physiological and body compositional changes cause changes in the pharmacokinetic and pharmacodynamic parameters. The increased central volume of distribution and alterations in the clearance of drugs affect the plasma concentration of propofol and remifentanil in the obese population. Additionally, obesity can affect pharmacodynamic properties, such as the 50% of maximal effective concentration and the effect-site equilibration rate constant (ke0). Conducting a simulation of target-controlled infusions based on pharmacokinetic and pharmacodynamic models that include patients that are obese can help clinicians better understand the pharmacokinetic and pharmacodynamic changes of anesthetic drugs associated with this population.


Prevalence of Depression and Associated Factors among Diabetic Patients at Mekelle City, North Ethiopia.
Coexistence of mental health problems on diabetes mellitus can result in poor management of the illness, poor adherence to treatment, and low quality of life. Therefore, it is highly crucial to assess these problems; thus we carried out this study with the aim of determining the prevalence of depression and identifying related factors among diabetic patients at city of Mekelle, North Ethiopia. Hospital-based cross-sectional study was employed among 264 diabetic patients, and participants were selected through systematic random sampling technique. We used local language versions of Beck Depression Inventory-II, Beck Anxiety Inventory, and Morisky 8 Item Medication Adherence Scale to assess the levels of depression, anxiety, and medication adherence, respectively. Socio-demographic and clinical factors were also assessed. We accomplish data entry, cleaning, and analysis through Statistical Package for Social Sciences window 20; also the level of significance was determined using adjusted odds ratio (OR). The prevalence of depression among diabetic patients is 17% (95% confidence interval [CI]: [12.9%, 21.6%]). In addition, 28% and 18.2% has low medication adherence and comorbid anxiety, respectively. We identify anxiety disorder (AOR = 10.52, 95% CI: [4.56, 24.28]), poor medication adherence (AOR = 4.38, 95%CI: [1.98, 9.64]), and coexistence of other physical illness (AOR = 3.04, 95% CI: [1.11, 8.34]) as risk factors for depression. Depression is a common mental health problem among diabetic patients which is related to poor treatment adherence coexistence of other physical illness and anxiety disorder. This emphasizes to formulate a mechanism for early detection and appropriate intervention.


Octopaminergic Signaling Mediates Neural Regulation of Innate Immunity in Caenorhabditis elegans.
Upon pathogen infection, the nervous system regulates innate immunity to confer coordinated protection to the host. However, the precise mechanisms of such regulation remain unclear. Previous studies have demonstrated that OCTR-1, a putative G protein-coupled receptor for catecholamine, functions in the sensory neurons designated "ASH" to suppress innate immune responses in Caenorhabditis elegans It is unknown what molecules act as OCTR-1 ligands in the neural immune regulatory circuit. Here we identify neurotransmitter octopamine (OA) as an endogenous ligand for OCTR-1 in immune regulation and show that the OA-producing RIC neurons function in the OCTR-1 neural circuit to suppress innate immunity. RIC neurons are deactivated in the presence of pathogens but transiently activated by nonpathogenic bacteria. Our data support a model whereby an octopaminergic immunoinhibitory pathway is tonically active under normal conditions to maintain immunological homeostasis or suppress unwanted innate immune responses but downregulated upon pathogen infection to allow enhanced innate immunity. As excessive innate immune responses have been linked to a myriad of human health concerns, our study could potentially benefit the development of more-effective treatments for innate immune disorders.IMPORTANCE Insufficient or excessive immune responses to pathogen infection are major causes of disease. Increasing evidence indicates that the nervous system regulates the immune system to help maintain immunological homeostasis. However, the precise mechanisms of this regulation are largely unknown. Here we show the existence of an octopaminergic immunoinhibitory pathway in Caenorhabditis elegans Our study results indicate that this pathway is tonically active under normal conditions to maintain immunological homeostasis or suppress unwanted innate immune responses but downregulated upon pathogen infection to allow enhanced innate immunity. As excessive innate immune responses have been linked to human health conditions such as Crohn's disease, rheumatoid arthritis, atherosclerosis, diabetes, and Alzheimer's disease, elucidating octopaminergic neural regulation of innate immunity could be helpful in the development of new treatments for innate immune diseases.


Anew Synthetic Polymers Based on Polyaniline for Dual-Functional Applications: Photoelectrochemical Water Splitting and Antibacterial Activities.
Polysulfanilic acid has a low efficiency for the photoelectrochemical (PEC) production of H2 from water splitting due to high recombination rate of charge and low electrical conductivity. Therefore, polyaniline was doped with polysulfanilic acid to form a copolymer and a blend to enhance its PEC heterogeneous catalytic performance. This was achieved through the improvement of visible light absorption and charge carriers' separation property. Herein, nine polymer samples of polysulfanilic acid were synthesized by oxidative polymerization. The structural, morphological, and optical properties of the synthesized polymeric materials were investigated. Interestingly, these polymer samples had multifunctional applications regarding their hydrogen generation efficiency. Photoelectrodes of different compositions from pure and blended polymers were prepared and used for the PEC solar hydrogen production from water. Different PEC parameters including the oxidant role, monochromatic illumination wavelength, and electrode reusability were optimized toward the efficient hydrogen generation. Moreover, the PEC performance was evaluated using key indicators such as photocurrent density, conversion efficiency, and the number of hydrogen moles. The number of hydrogen moles was quantitatively estimated to be 140.4, 160.2, and 300 μmol/h·g at -1 V for the polymer, copolymer, and polymer blend, respectively, in the presence of APS + FeCl3 as an oxidant. Further, other samples of polymers showed antimicrobial properties against different species of bacteria. Hence, the present study may provide a cost-effective method to produce solar hydrogen fuel from water.


Obesity Alters the Muscle Protein Synthetic Response to Nutrition and Exercise.
Improving the health of skeletal muscle is an important component of obesity treatment. Apart from allowing for physical activity, skeletal muscle tissue is fundamental for the regulation of postprandial macronutrient metabolism, a time period that represents when metabolic derangements are most often observed in adults with obesity. In order for skeletal muscle to retain its capacity for physical activity and macronutrient metabolism, its protein quantity and composition must be maintained through the efficient degradation and resynthesis for proper tissue homeostasis. Life-style behaviors such as increasing physical activity and higher protein diets are front-line treatment strategies to enhance muscle protein remodeling by primarily stimulating protein synthesis rates. However, the muscle of individuals with obesity appears to be resistant to the anabolic action of targeted exercise regimes and protein ingestion when compared to normal-weight adults. This indicates impaired muscle protein remodeling in response to the main anabolic stimuli to human skeletal muscle tissue is contributing to poor muscle health with obesity. Deranged anabolic signaling related to insulin resistance, lipid accumulation, and/or systemic/muscle inflammation are likely at the root of the anabolic resistance of muscle protein synthesis rates with obesity. The purpose of this review is to discuss the impact of protein ingestion and exercise on muscle protein remodeling in people with obesity, and the potential mechanisms underlining anabolic resistance of their muscle.


[Thyroid surgery applicable in developing countries].
Thyroid surgery in developing countries is performed by general surgeons with limited diagnostic and therapeutic resources. The aim of this review is to describe the indications for and appropriate type of surgery according to the diseases observed. Endemic goiter (grade 1 and 2) usually regresses with iodine therapy. Surgery is indicated only for its complications: mechanical, neoplastic, or related to hyperthyroidism. The choice of operation depends on the specific disease and also on the likelihood that thyroxine will be continuously available for the patient's lifetime. Total thyroidectomy should be avoided whenever possible if thyroxine supplies are unreliable. Hemithyroidectomy and subtotal thyroidectomy are the techniques that should be used in priority.


Multinational study of cancer patients and their children: factors associated with family functioning.
This study examined factors associated with family functioning in cancer patients' families with dependent children. A sample of 381 families (639 parents and 489 children) was recruited simultaneously in six European countries. Patients and family members completed a background questionnaire, the Family Assessment Device (FAD), the Beck Depression Inventory, and the short form version of the Medical Outcomes Health Survey. Descriptive statistics and a multilevel model that allowed a multi-informant design were used. Analyses were carried out with all participants, and separately with parent-rated and children-rated FAD scores. In descriptive analyses, children reported more impairment in family functioning than parents, but the difference was not significant. Depression prevalence was 35% for ill mothers and 28% for ill fathers. In the multilevel analyses with all participants (ie, adults and children) the ill parent's depression was significantly associated with impaired family functioning on five of seven FAD subscales. In analyses with only children, the perception of impairment of family functioning was not associated with parental depression. Additionally, poorer physical status of the ill parent was significantly associated with impairment on roles and communication. The ill parent's depression was the most significant factor associated with impairment in family functioning. Screening for depression, active diagnostics, and appropriate treatment of cancer patient's and partner's depression may be important to protect their children from mental disorders. Therefore, support systems need to be more family-oriented and child-centered in their approaches to cancer psychosocial care.


Improving Embedding Generalization in Few-Shot Learning With Instance Neighbor Constraints.
Recently, metric-based meta-learning methods have been effectively applied to few-shot image classification. These methods classify images based on the relationship between samples in an embedding space, avoiding over-fitting that can occur when training classifiers with limited samples. However, finding an embedding space with good generalization properties remains a challenge. Our work highlights that having an initial manifold space that preserves sample neighbor relationships can prevent the metric model from reaching a suboptimal solution. We propose a feature learning method that leverages Instance Neighbor Constraints (INC). This theory is thoroughly evaluated and analyzed through experiments, demonstrating its effectiveness in improving the efficiency of learning and the overall performance of the model. We further integrate the INC into an alternate optimization training framework (AOT) that leverages both batch learning and episode learning to better optimize the metric-based model. We conduct extensive experiments on 5-way 1-shot and 5-way 5-shot settings on four popular few-shot image benchmarks: miniImageNet, tieredImageNet, Fewshot-CIFAR100 (FC100), and Caltech-UCSD Birds-200-2011(CUB). Results show that our method achieves consistent performance gains on benchmarks and state-of-the-art performance. Our findings suggest that initializing the embedding space appropriately and leveraging both batch and episode learning can significantly improve few-shot learning performance.


[Indication and efficiency of different operations in congenital hip dislocation (author's transl)].
The efficiency of different operations for congenital hip dysplasia is discussed here. Up to the age of 6 years Salters osteotomy and the acetabuloplasty of Lance in a modified form will achieve similar results. In cases with an acetabular index higher than 35 degrees acetabuloplasty is more effective. After our own experience acetabuloplasty can be used in all age groups where there is no congruency between acetabulum and femoral head. In congruent cases Salters osteotomy can be used up to 14 years combined with varus-osteotomy if dysplasia is of moderate degree. Chiaris osteotomy should be reserved for extreme cases, where other methods will not succeed.


Is fertility associated with the number of siblings of the couple? Evidence from India.
The influence of family on an individual's fertility has long been an important topic of interest in fertility research. Although studies conducted mostly in developed countries found a significant bearing of fertility of the parents on the fertility of the children, there is a lack of formal research around this topic in India. The present study analyses the effect of sibling size of husband and wife on the completed family size of women using information of 5506 ever-married women aged 45-49 years incorporated in the India Human Development Survey-II (2011-2012). Inferential statistics, bivariate, Chi-square and Poisson regression were used as the methods of analysis. The unadjusted estimates of Poisson regression reveal sibling size of women (IRR: 1.02; p < 0.001) and husband (IRR: 1.01; p < 0.001) have a positive correlation with the completed family size of women. However, in the adjusted model, the effect of sibling size especially of husband diminishes gradually in the presence of socio-economic covariates of the women.


Identifying behavioural determinants for interventions to increase handwashing practices among primary school children in rural Burundi and urban Zimbabwe.
This article presents the development of a school handwashing programme in two different sub-Saharan countries that applies the RANAS (risk, attitudes, norms, ability, and self-regulation) systematic approach to behaviour change. Interviews were conducted with 669 children enrolled in 20 primary schools in Burundi and 524 children in 20 primary schools in Zimbabwe. Regression analyses were used to assess the influence of the RANAS behavioural determinants on reported handwashing frequencies. The results revealed that, in both countries, a programme targeting social norms and self-efficacy would be most effective. In Burundi, raising the children's perceived severity of the consequences of contracting diarrhoea, and in Zimbabwe, increasing the children's health knowledge should be part of the programme. The school handwashing programme should create awareness of the benefits of handwashing through educational activities, raise the children's ability and confidence in washing hands at school through infrastructural improvements, and highlight the normality of washing hands at school through events and poster creation.


Distress Tolerance Interacts With Negative Life Events to Predict Depressive Symptoms Across Adolescence.
Adolescence is a vulnerable period for the development of depressive disorders. Recent research has demonstrated the importance of distress tolerance in the onset and maintenance of depression during adulthood; however, little is known about its role in predicting depressive symptoms among adolescents. The current study examines the effect of distress tolerance and co-occurring negative life events on the developmental trajectory of depressive symptoms from middle to late adolescence. Our sample included 117 adolescent boys and girls (44.4% female, 54.6% White). Participants were, on average, 16 years old at baseline (SD = 0.90) and completed self-report inventories of negative life events and depressive symptoms; distress tolerance was assessed using a behavioral measure. Utilizing a latent growth curve approach, we found a significant interaction between distress tolerance and negative life events in predicting increases in depressive symptoms over time. Follow-up analyses suggest that negative life events were associated with greater increases in depressive symptoms over time for adolescents with lower levels of distress tolerance only. The study highlights the moderating role of distress intolerance in the relation between negative life events and depressive symptoms, and underscores the importance of targeting distress tolerance for treating depression among youth.


Risk factors of foot ulcers in patients with end-stage renal disease on dialysis: A meta-analysis.
The present study aims to assess the risk factors for foot ulcers in patients undergoing dialysis for end-stage renal disease (ESRD) and to provide evidence-based guidance for prevention and treatment. A systematic search was conducted on PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure, Chinese Biomedical Literature Database and Wanfang Data from the database inception until May 2023 to identify relevant studies investigating the risk factors for foot ulcers in dialysis patients with ESRD. Two independent researchers conducted the literature screening and data extraction. The meta-analysis was performed using STATA 17.0 software. Ultimately, six articles comprising 1620 patients were included for analysis. The meta-analysis revealed that male (OR, 1.464; 95% CI: 1.082-1.980, p = 0.013), hypertension (OR, 1.781; 95% CI: 1.293-2.4550, p < 0.001), peripheral artery disease (PAD) (OR, 5.014; 95% CI: 2.514-9.998, p < 0.001), type 1 diabetes mellitus (T1DM) (OR, 2.993; 95% CI: 1.477-6.065, p = 0.002) and type 2 diabetes mellitus (T2DM) (OR, 2.498; 95% CI:1.466-4.256, p = 0.001) were risk factors for foot ulcers in dialysis patients with ESRD. Conversely, the female sex (OR, 0.683; 95% CI: 0.505-0.924, p = 0.013) was a protective factor against foot ulcers. Our analysis revealed that male sex, hypertension, PAD, T1DM and T2DM were risk factors for foot ulcers in patients undergoing dialysis for ESRD. Conversely, the female sex was a protective factor against foot ulcers. Therefore, it is crucial to strengthen health education that targets patients with these risk factors and regularly screen high-risk individuals. Early detection and treatment can help delay disease progression.


Examining the role of effective population size on mitochondrial and multilocus divergence time discordance in a songbird.
Estimates of speciation times are subject to a number of potential errors. One source of bias is that effective population size (Ne) has been shown to influence substitution rates. This issue is of particular interest for phylogeographic studies because population sizes can vary dramatically among genetically structured populations across species' ranges. In this study, we used multilocus data to examine temporal phylogeographic patterns in a widespread North American songbird, the Northern Cardinal (Cardinalis cardinalis). Species tree estimation indicated that the phylogeographic structure of C. cardinalis was comprised of four well-supported mainland lineages with large population sizes (large Ne) and two island lineages comprised of much smaller populations (small Ne). We inferred speciation times from mtDNA and multilocus data and found there was discordance between events that represented island-mainland divergences, whereas both estimates were similar for divergences among mainland lineages. We performed coalescent simulations and found that the difference in speciation times could be attributed to stochasticity for a recently diverged island lineage. However, the magnitude of the change between speciation times estimated from mtDNA and multilocus data of an older island lineage was substantially greater than predicted by coalescent simulations. For this divergence, we found the discordance in time estimates was due to a substantial increase in the mtDNA substitution rate in the small island population. These findings indicate that in phylogeographic studies the relative tempo of evolution between mtDNA and nuclear DNA can become highly discordant in small populations.


A cone-beam computed tomography study of hyoid bone position and airway volume in subjects with obstructive and nonobstructive adenotonsillar hypertrophy.
To investigate hyoid bone position and airway volume in subjects with adenoid hypertrophy, tonsillar hypertrophy, and adenotonsillar hypertrophy compared to subjects with nonobstructive adenoids or tonsils and to assess the correlation between hyoid bone and airway parameters. A total of 121 subjects were grouped based on adenoid or tonsillar hypertrophy into four groups, as follows: (1) control group (C-group), (2) adenoid hypertrophy group (AH-group), (3) adenotonsillar hypertrophy group (ATH-group), and (4) tonsillar hypertrophy group (TH-group). Hyoid bone position and airway volumes were measured. The Kruskal-Wallis test was used for intergroup comparison, followed by pairwise comparison using the Mann-Whitney U-test. Bivariate correlation was conducted using Spearman correlation coefficients. Multiple linear regression was performed to create a model for airway volume based on hyoid bone predictive variables. No significant difference was found between subjects with isolated adenoid or tonsillar hypertrophy compared to the C-group. However, the ATH-group exhibited a significantly decreased hyoid bone vertical distance (HV), total airway volume (TA volume), and retroglossal airway volume (RG volume) compared to the C-group. HV and age had a high potential in terms of explaining the RG volume, whereas the TA volume and retropalatal airway volume (RP volume) models were not as successful as the RG volume counterpart. Subjects in ATH-group were characterized by an elevated hyoid bone position and constricted TA volume and RG volume compared to those in the C-group. HV and age were predictor variables that best explained retroglossal airway volume.


[Calcium channel mediated calcium release from the rabbit skeletal muscle sarcoplasmic reticulum vesicle].
Activation and inhibition of the calcium release channel of rabbit skeletal muscle heavy sarcoplasmic reticulum (HSR) was investigated by various methods. The calcium release channel is activated by binding of calcium in the micromolar range and by binding of adenine nucleotides in the millimolar range. Ruthenium red and neomycin are potent inhibitors of the channel at nanomolar to micromolar concentrations. Dantrolene inhibits the rate of caffeine-induced calcium release. Several models of the calcium release channel were considered to explain the three-phasic calcium release from HSR vesicles. Simulation of calcium efflux data according to various models suggest that the calcium release channel has at least three states. The experimental results can be explained by assuming one open and two closed states of the calcium release channel, but not by assuming one open and one closed state.


Vine-twining polymerization: a new preparation method for well-defined supramolecules composed of amylose and synthetic polymers.
In this article we describe a new method of polymerization called "vine-twining polymerization" for preparation of well-defined supramolecules, which are amylose-polymer inclusion complexes. The method was achieved by enzymatic polymerization of alpha-D-glucose-1-phosphate catalyzed by phosphorylase in the presence of various synthetic polymers such as polyethers, polyesters, poly(ester-ether), and amphiphilic block copolymer. Powder X-ray diffraction (XRD) and 1H-NMR measurements determined the structures of the products to be inclusion complexes. The XRD patterns were completely different from those of amylose and guest polymers. The 1H-NMR spectra of the products indicated that the structures were composed of amylose and guest polymers. The formation process of the inclusion complexes during the enzymatic polymerization was also evaluated. In addition, we revealed that the bulkiness of the end groups and the hydrophobicity of the guest polymers strongly affected the formation of the inclusion complexes. By means of this method of polymerization, a graft polymer having inclusion complexes as side chains was prepared. Furthermore, as an evolution of the "vine-twining polymerization," we attempted a system of parallel polymerization to form an inclusion complex of amylose with a strongly hydrophobic guest polymer.


Genetic Variations of Tyrosine Hydroxylase in the Pathogenesis of Hypertension.
One of the major pathophysiological features of primary hypertension is an inappropriate activation of the sympathetic nervous system, which is mediated by excessive synthesis and secretion of catecholamine into the blood. Tyrosine hydroxylase (TH), a rate-limiting enzyme in the synthesis of catecholamine, has been highlighted because genetic variations of TH could alter the activity of the sympathetic nervous system activity and subsequently contribute to the pathogenesis of hypertension. Here, we discuss the role of TH as a regulator of sympathetic activity and review several studies that investigated the relationship between genetic variations of TH and hypertension.


Current status of assisted reproductive technology in Korea, 2009.
Great advances have been made in the field of assisted reproductive technology (ART) since the first in vitro fertilization (IVF) baby was born in Korea in the year of 1985. However, it deserve to say that the invaluable data from fertility centers may serve as a useful source to find out which factors affect successful IVF outcome and to offer applicable information to infertile patients and fertility clinics. This article intended to report the status of ART in 2009 Korean Society of Obstetrics and Gynecology surveyed. The current survey was performed to assess the status and success rate of ART performed in Korea, between January 1 and December 31, 2009. Reporting forms had been sent out to IVF centers via e-mail, and collected by e-mail as well in 2012. With International Committee Monitoring Assisted Reproductive Technologies recommendation, intracytoplasmic sperm injection (ICSI) and non-ICSI cases have been categorized and also IVF-ET cases involving frozen embryo replacement have been surveyed separately. Seventy-four centers have reported the treatment cycles initiated in the year of 2009, and had performed a total of 27,947 cycles of ART treatments. Among a total of 27,947 treatment cycles, IVF and ICSI cases added up to 22,049 (78.9%), with 45.3% IVF without ICSI and 54.7% IVF with ICSI, respectively. Among the IVF and ICSI patients, patients confirmed to have achieved clinical pregnancy was 28.8% per cycle with oocyte retrieval, and 30.9% per cycle with embryo transfer. The most common number of embryos transferred in 2009 is three embryos (40.4%), followed by 2 embryos (28.4%) and a single embryo transferred (13.6%). Among IVF and ICSI cycles that resulted in multiple live births, twin pregnancy rate was 45.3% and triple pregnancy rate was 1.1%. A total of 191 cases of oocyte donation had been performed to result in 25.0% of live birth rate. Meanwhile, a total of 5,619 cases of frozen embryo replacement had been performed with 33.7% of clinical pregnancy rate per cycle with embryo transfer. When comparing with international registry data, clinical pregnancy rate per transfer from fresh IVF cycles including ICSI (34.1%,) was comparable to clinical pregnancy rate per transfer in European Society for Human Reproduction and Embryology report was 32.5% though lower than 45.0% for USA data. There was no remarkable difference in status of assisted reproductive technology in Korea between the current report and the data reported in 2008. The age of women trying to get pregnant was reconfirmed to be the most important factor that may have impact on success of ART treatment.


Chronic At1 receptor blockade alters the mechanisms mediating hypoxic dilation in middle cerebral arteries.
The purpose of this study was to determine whether chronic blockade of the angiotensin II (ANG II) AT1 receptor under normal physiological conditions impairs vascular relaxation mechanisms in isolated middle cerebral arteries (MCA). Male Sprague-Dawley rats on a standard diet were given losartan (1 mg/mL) in the drinking water or normal water ad libitum for 7 days. Vessel diameters were measured by television microscopy before and during exposure to various vasodilator agonists and reductions in PO2 from 140 mm Hg to 35-45 mm Hg. Dilations to acetylcholine (1 microM), the stable prostacyclin analogue iloprost (10 pg/mL), and the Gs protein activator cholera toxin (1 ng/mL) were completely eliminated in vessels from losartan-treated animals. However, middle cerebral arteries from control and losartan-treated rats still demonstrated significant dilations in response to reduced PO2. Hypoxic dilation of middle cerebral arteries from control rats was eliminated by indomethacin (1 microM) and unaffected by the NOS inhibitor L-NAME (100 microM) whereas dilation in response to reduced PO2 in middle cerebral arteries from losartan-treated rats was eliminated by L-NAME and unaffected by indomethacin. Middle cerebral arteries from control and losartan-treated animals exhibited similar dilations in response to the NO-donor sodium nitroprusside (1 microM). These data suggest that AT1 receptor activation is important in maintaining normal vascular relaxation mechanisms in cerebral resistance arteries during normal physiological conditions, and that AT1 receptor blockade causes a shift in the mechanisms of hypoxic dilation of middle cerebral arteries from cyclooxygenase metabolites to NO.


Evaluation of PD-L1/PD-1 on circulating tumor cells in patients with advanced non-small cell lung cancer.
Circulating tumor cells (CTCs) could escape from the immune system through the programmed death-ligand 1 (PD-L1)/programmed cell death protein 1 (PD-1) axis leading to the development of metastasis. The current study investigated the expression of PD-1/PD-L1 on CTCs isolated from non-small cell lung cancer (NSCLC) patients treated with chemotherapy. CTCs were isolated from 30 chemo-naïve stage IV NSCLC patients before and after front-line chemotherapy using the ISET filtration platform. CTCs were detected by Giemsa and immunofluorescence (IF) staining. Samples were analyzed with the ARIOL system. Giemsa staining revealed that 28 (93.3%) out of 30 and 9 (81.8%) out of 11 patients had detectable CTCs at baseline and after the third chemotherapy cycle, respectively. Cytokeratin (CK)+/CD45- CTCs by IF could be detected in 17 of 30 (56.7%) patients at baseline and in 8 of 11 (72.7%) after the third chemotherapy cycle. Spearman analysis revealed a significant correlation (p = 0.001) between Giemsa-positive and IF-positive (CK+/CD45-) CTCs. At baseline, PD-1 and PD-L1 expression was observed in 53% and in 47% CK-positive patients, respectively. After the third treatment cycle the corresponding numbers were 13% and 63% respectively. Median progression-free survival (PFS) was significantly shorter in patients with >3 PD-1(+) CTCs at baseline compared with those with <3 PD-1(+) CTCs (p = 0.022) as well as in patients with >1 Giemsa-positive tumor cells (p = 0.025). PD-1(+) and PD-L1(+) CTCs could be detected before and after front-line chemotherapy in patients with metastatic NSCLC. The presence of high PD-1(+) CTC numbers before treatment is associated with a poor patient clinical outcome.


[Randomized clinical trial of cis-platinum diamminedichloride (PDD) in the treatment of hepatocellular carcinoma (HCC)].
From Oct. 1982 to Apr. 1985, 82 patients with HCC proven by pathology were treated in our hospital. 43 treated by hepatic arterial perfusion, were randomized into PDD group: PDD 10 mg per day X 10, every 3 weeks; control group: fluorouracil (5-Fu) 250 mg per day X 4, every week and thio-tepa (TSPA) 10 mg, twice a week. The other 39 treated by intravenous chemotherapy, were also randomized into PDD group: PDD 20 mg per day X 5, every 3 weeks; control group: 5-Fu 500 mg and TSPA 10 mg, twice a week. The objective response rates were 31.8% (7/22) in PDD group and 23.8% (5/21) in control group by hepatic arterial perfusion, and 20.0% (4/20) in the former and 0% (0/19) in the latter who were treated intravenously. The median survivals were 8 months for all the patients receiving hepatic arterial perfusion, and 6 and 5 months for the intravenous PDD and its control group, respectively. The side effects and kidney toxicity of PDD were tolerable to the patients. It is observed that PDD is better than 5-Fu and TSPA in the treatment of HCC.


Food processing by high hydrostatic pressure.
High hydrostatic pressure (HHP) process, as a nonthermal process, can be used to inactivate microbes while minimizing chemical reactions in food. In this regard, a HHP level of 100 MPa (986.9 atm/1019.7 kgf/cm2) and more is applied to food. Conventional thermal process damages food components relating color, flavor, and nutrition via enhanced chemical reactions. However, HHP process minimizes the damages and inactivates microbes toward processing high quality safe foods. The first commercial HHP-processed foods were launched in 1990 as fruit products such as jams, and then some other products have been commercialized: retort rice products (enhanced water impregnation), cooked hams and sausages (shelf life extension), soy sauce with minimized salt (short-time fermentation owing to enhanced enzymatic reactions), and beverages (shelf life extension). The characteristics of HHP food processing are reviewed from viewpoints of nonthermal process, history, research and development, physical and biochemical changes, and processing equipment.


[Epidemiology of breast cancer].
Important facts and hypotheses of descriptive and analytic epidemiology of breast cancer are presented and discussed in connection with results of studies carried out by the authors. Leading position and further increase in breast cancer incidence in many countries are the most important point of descriptive epidemiology. In the GDR breast cancer incidence amounts to 60 per 100,000 per year. On the other hand, there are large differences in the incidence between populations, which support hypotheses about the life style, especially of diet, as a risk factor for breast cancer. The most important groups of risk factors which have been investigated are menstrual and reproductive factors, genetics, hormonal status, diet, benign breast disease, radiation and oral contraceptives. Early age at menarche and late age at menopause, nulliparity and late age at first birth, breast cancer in first-degree relatives, benign breast disease and radiation increase breast cancer risk. The results of case-control studies concerning diet are not yet convincing. A number of studies shows no overall increase of breast cancer risk. Finally, possibilities of breast cancer control are discussed.


THE EVOLUTION OF PARASITES FROM THEIR HOSTS: A CASE STUDY IN THE PARASITIC RED ALGAE.
Morphological similarities of many parasites and their hosts have led to speculation that some groups of plant, animal, fungal, and algal parasites may have evolved directly from their hosts. These parasites, which have been termed adelphoparasites in the botanical literature, and more recently, agastoparasites in the insect literature, may evolve monophyletically from one host and radiate secondarily to other hosts or, these parasites may arise polyphyletically, each arising from its own host. In this study we compare the internal transcribed spacer regions of the nuclear ribosomal repeats of species and formae specialis (host races) included in the red algal parasite genus Asterocolax with its hosts, which all belong to the Phycodrys group of the Delesseriaceae and with closely related nonhost taxa of the Delesseriaceae. These analyses reveal that species of Asterocolax have evolved polyphyletically. Asterocolax erythroglossi from the North Atlantic host Erythroglossum laciniatum appears to have evolved from its host, whereas taxa included in the north Pacific species Asterocolax gardneri have had two independent origins. Asterocolax gardneri from the host Polyneura latissima probably arose directly from this host. In contrast, all other A. gardneri formae specialis appear to have originated from either Phycodrys setchellii or P. isabelliae and radiated secondarily onto other closely related taxa of the Phycodrys group, including Nienburgia andersoniana and Anisocladella pacifica. Gamete crossing experiments confirm that A. gardneri from each host is genetically isolated from both its host, and from other A. gardneri and their hosts. Cross-infection experiments reveal that A. gardneri develops normally only on its natural host, although some abberrant growth may occur on alternate hosts. The ability of red algal parasites to radiate secondarily to other red algal taxa, where they may become isolated genetically and speciate, suggests that this process of speciation is not a "genetic dead end" but one that may give rise to related clusters of parasite species.


Ultra-light planar meta-absorber with wideband and full-polarization properties.
Absorbers have high potential application values in the military field, such as electronic screening, radar cross-section reduction and invisible cloaking. However, most methods have the defects of narrow bandwidth, low absorptivity, complex three-dimensional structure and fixed polarizations. In this paper, we realize an ultra-broadband and full-polarization planar metamaterial absorber (PMA) with a three-layer composite structure, which exhibits multi-resonant and impedance matching properties by combining the ultra-light foams and indium tin oxide (ITO) films. The bottom two layers achieve a high-efficiency absorption rate at the low and medium spectrum, while the upper layer realizes a absorption property at a high frequency. Also, an equivalent circuit model is extracted to explain its operating mechanism. The experimental results show that our meta-absorber can achieve great absorber performance of better than 90% within 1-18 GHz for full-polarization incident waves, which is in great agreement with the numerical simulations. Moreover, our device is insensitive to oblique incidences and polarizations and possesses the physical characteristics of an ultralight, weighing 0.6 kg for a square meter, which is only 1/85.0-1/126.7 of the conventional absorbers under the same size. All these excellent performances determine that our research can be a good candidate for military stealth materials.


Formation and oxidation state of CeO(2-x) nanotubes.
Well-crystalline CeO(2-x) nanotubes are synthesized via a mild hydrothermal reaction route using cerium nitrate and ammonium hydroxide as reactants. The CeO(2-x) nanotubes have the same structure as the bulk CeO2 but larger lattice parameter. The measurement of the ratio of M5/M4 edge shows the valence reduction of cerium ions for the CeO(2-x) nanotubes.


Preclinical Mouse Models To Study Human OATP1B1- and OATP1B3-Mediated Drug-Drug Interactions in Vivo.
The impact of OATP drug uptake transporters in drug-drug interactions (DDIs) is increasingly recognized. OATP1B1 and OATP1B3 are human hepatic uptake transporters that can mediate liver uptake of a wide variety of drugs. Recently, we generated transgenic mice with liver-specific expression of human OATP1B1 or OATP1B3 in a mouse Oatp1a/1b knockout background. Here, we investigated the applicability of these mice in OATP-mediated drug-drug interaction studies using the prototypic OATP inhibitor rifampicin and a good OATP substrate, the anticancer drug methotrexate (MTX). We next assessed the possibility of OATP-mediated interactions between telmisartan and MTX, a clinically relevant drug combination. Using HEK293 cells overexpressing OATP1B1 or OATP1B3, we estimated IC50 values for both rifampicin (0.9 or 0.3 μM) and telmisartan (6.7 or 7.9 μM) in inhibiting OATP-mediated MTX uptake in vitro. Using wild-type, Oatp1a/1b-/-, and OATP1B1- or OATP1B3-humanized transgenic mice, we found that rifampicin inhibits hepatic uptake of MTX mediated by the mouse Oatp1a/1b and human OATP1B1 and OATP1B3 transporters at clinically relevant concentrations. This highlights the applicability of these mouse models for DDI studies and may be exploited in the clinic to reduce the dose and thus methotrexate-mediated toxicity. On the other hand, telmisartan inhibited only human OATP1B1-mediated hepatic uptake of MTX at concentrations higher than those used in the clinic; therefore risks for OATP-mediated clinical DDIs for this drug combination are likely to be low. Overall, we show here that OATP1B1- and OATP1B3-humanized mice can be used as in vivo tools to assess and possibly predict clinically relevant DDIs.


Exclusion of galectin 9 as a candidate gene for hyperuricosuria in the Dalmatian dog.
All Dalmatian dogs have an inherited defect in purine metabolism leading to high levels of uric acid excretion in their urine (hyperuricosuria) rather than allantoin, the normal end product of purine metabolism in all other breeds of dog. Transplantation experiments have demonstrated that the defect is intrinsic to the liver and not the kidney. Uricase, the enzyme involved in the breakdown of urate into allantoin, has been shown to function in Dalmatian liver cells. Therefore, candidate genes for this defect include transporters of urate, a salt of uric acid, across cell membranes. We excluded one such urate transporter candidate, galectin 9, using a Dalmatian x Pointer backcross in which hyperuricosuria was segregating.


Evaluation of nanoparticle-ligand distributions to determine nanoparticle concentration.
The concentration of nanoparticles in solution is an important, yet challenging, parameter to quantify. In this work, a facile strategy for the determination of nanoparticle concentration is presented. The method relies on the quantitative analysis of the inherent distribution of nanoparticle-ligand conjugates that are generated when nanoparticles are functionalized with ligands. Validation of the method was accomplished by applying it to gold nanoparticles and semiconductor nanoparticles (CdSe/ZnS; core/shell). Poly(ethylene glycol) based ligands, with functional groups that quantitatively react with the nanoparticles, were incubated with the nanoparticles at varying equivalences. Agarose gel electrophoresis was subsequently used to separate and quantify the nanoparticle-ligand conjugates of varying valences. The distribution in the nanoparticle-ligand conjugates agreed well with that predicted by the Poisson model. A protocol was then developed, where a series of only eight different ligand amounts could provide an estimate of the nanoparticle concentration that spans 3 orders of magnitude (1 μM to 1 mM). For the gold nanoparticles and semiconductor nanoparticles, the measured concentrations were found to deviate by only 7% and 2%, respectively, from those determined by UV-vis spectroscopy. The precision of the assay was evaluated, resulting in a coefficient of variation of 5-7%. Finally, the protocol was used to determine the extinction coefficient of alloyed semiconductor nanoparticles (CdSxSe1-x/ZnS), for which a reliable estimate is currently unavailable, of three different emission wavelengths (525, 575, and 630 nm). The extinction coefficient of the nanoparticles of all emission wavelengths was similar and was found to be 2.1 × 10(5) M(-1)cm(-1).


Alterations induced in distribution and in vivo metabolism of imipramine by pregnenolone-16alpha-carbonitrile.
Female rats were given pregnenolone-16alpha-carbonitrile (I) to investigate its in vivo effects on the loss of the righting reflex and the mortality rate induced by imipramine as well as the concentrations of this drug and its metabolite, desipramine, in plasma, brain, liver, lungs, and kidneys. The protective action of I was associated with diminished organ levels of imipramine (catatoxic mechanism), and the relationship between brain and plasma imipramine concentrations remained unaltered. Desipramine-imipramine molar ratios were increased, indicating an elevated rate of N-demethylation. The unbound imipramine in plasma was diminished, but the relationship between protein-bound and unbound imipramine levels was not modified.


VDAC channels differentiate between natural metabolites and synthetic molecules.
VDAC provides the major permeability pathway through the mitochondrial outer membrane by forming voltage-gated channels with pore radius of 1.2-1.5 nm. We find that VDAC can select among comparably-charged molecules with a much smaller effective radius, 0.4-0.5 nm. The molecules studied were the nucleotides, ATP, UTP, NADH and synthetic anions, tetraglutamate (T-Glu) and 1-hydroxypyrene-3,6,8-trisulfonate (HPTS). VDAC channels were reconstituted into planar phospholipid membranes bathed in 1.0 M NaCl (buffered to pH 8.0). The nucleotides decreased the conductance of VDAC for NaCl demonstrating that they could permeate into the channel. In contrast, T-Glu and HPTS did not change the single-channel conductance, indicating exclusion from the channel. Reversal potential measurements report near ideal selectivity of Na + over T-Glu. The nucleotides increased single-channel noise as they penetrated into the channel, while T-Glu had no effect. HPTS increased noise, but unlike NADH, this was not voltage-dependent when HPTS was added asymmetrically, indicating no penetration into the channel. The differences in effective size and charge cannot explain the difference in permeation characteristics. Thus VDAC must select among these based on shape and charge distribution. We propose that the electrostatic environment within the channel has been evolutionarily selected to favor the passage of adenine nucleotides.


[A case of primary small cell carcinoma arising from the common bile duct].
Small cell carcinoma is usually seen in the lung, but rarely involves the gastrointestinal tract including biliary tract. A 65 year-old man was admitted because of obstructive jaundice. A smooth-surfaced round intraluminal mass with proximal bile duct dilatation was seen in the proximal common bile duct on endoscopic retrograde cholangiogram. Under the diagnosis of bile duct cancer, pylorus-preserving pancreatoduodenectomy was done. Pathology revealed a 2 cm sized small cell carcinoma in the proximal common bile duct and distal common hepatic duct. On immunohistochemical stain, the tumor cells were positive for neuroendocrine markers CD56 and synaptophysin. After surgery, the patient received 5 cycles of adjuvant chemotherapy with VIP (etoposide, ifosfamide, and cisplatin) regimen. However, the patient died of liver metastasis 12 months after the diagnosis. We report a case of extrapulmonary small cell carcinoma arising from the common bile duct.


Six-telescope integrated optics beam combiner fabricated using ultrafast laser inscription for J- and H-band astronomy.
We have built and characterized, to our knowledge, the first six-telescope discrete beam combiner (DBC) for stellar interferometry in the astronomical J-band. It is the DBC with the largest number of beam combinations and was manufactured using ultrafast laser inscription in borosilicate glass, with a throughput of ≈56%. For calibration of the visibility-to-pixel matrix, we use a two-input Michelson interferometer and extract the complex visibility. A visibility amplitude of 1.05 and relative precision of 2.9% and 3.8% are extracted for 1328 nm and 1380 nm, respectively. Broadband (≤40n m) characterization is affected by dispersion but shows similar performance.


Observation of calcium phosphate powder mixed with an adhesive monomer experimentally developed for direct pulp capping and as a bonding agent.
In this study, morphological shape, elemental distribution and elution properties of Ca, P, Mg in four types of calcium phosphate powder were investigated using SEM, EPMA and ICP-AES. Calcium phosphate powder: OHAp, DCPD, beta-TCP and OCP were observed in the white powder form and in the photopolymerized adhesive monomer they scattered like dispersed fillers in resin composite. In elemental analysis, CaKalpha showed a relatively high concentration in relation to PKalpha. In elution analysis, each calcium phosphate showed different elution of Ca and P. But Mg was almost equal to the detection limit of ICP-AES. Namely it was suggested that reparative dentin formation was effectively promoted under the following conditions: a calcification promoting effect by direct contact of the calcium phosphate powder, an ionic effect of Ca and P eluted from the powder located in the vicinity of the exposed pulp and environmental pH change of the surface in exposed pulp.


Principles of nasal reconstruction.
The human nose poses a difficult problem to the management of cutaneous malignancies, especially basal-cell carcinoma. Located in the center of the face, it is frequently involved with skin tumor, yet its prominent location and graceful contours present a formidable reconstructive challenge. Histographic excision of the lesion with immediate plastic surgical reconstruction offers the best prospects for tumor control with the least residual deformity.


Impact of glutathione S-transferase M1 and T1 gene polymorphisms on the smoking-related coronary artery disease.
Glutathione S-transferase (GST) plays a key role in the detoxification of xenobiotic atherogen generated by smoking. To analyze the effect of GSTM1/T1 gene polymorphisms on the development of smoking-related coronary artery disease (CAD), 775 Korean patients who underwent coronary angiography were enrolled. The subjects were classified by luminal diameter stenosis into group A (>50%), B (20-50%), or C (<20%). GSTM1 and GSTT1 gene polymorphisms were analyzed using multiplex polymerase chain reaction (PCR) for GSTM1/T1 genes and CYP1A1 gene for internal control. Of 775 subjects, 403 patients belonged to group A. They had higher risk factors for CAD than group B (N=260) and group C (N=112). The genotype frequencies of null GSTM1 and GSTT1 showed no significant differences among 3 groups. Considering the effect of GSTM1 gene polymorphisms on the smoking-related CAD, smokers with GSTM1 null genotype had more increased risk for CAD than non-smoker with GSTM1 positive genotype (odds ratios [OR], 2.07, confidence interval [CI], 1.06-4.07). Also the effect of GSTT1 gene polymorphism on smoking-related CAD showed the same tendency as GSTM1 gene (OR, 2.00, CI, 1.05-3.84). This effect of GSTM1/T1 null genotype on smoking-related CAD was augmented when both gene polymorphisms were considered simultaneously (OR, 2.76, CI, 1.17-6.52). We concluded that GSTM1/T1 null genotype contributed to the pathogenesis of smoking-related CAD to some degree.


Characterization of colorectal tumors using narrow-band imaging magnification: combined diagnosis with both pit pattern and microvessel features.
We aimed to clarify the clinical usefulness of narrow-band imaging (NBI) magnification for evaluating both pit appearances and microvessel architecture in comparison with evaluation of microvessel architecture alone in invasion depth of colorectal tumors. A total of 189 colorectal lesions [37 adenomas, 73 intramucosal to scanty submucosal invasive carcinomas and 79 massive submucosal invasive (SM-m) carcinomas] were analyzed. All lesions showing irregular pit structure were observed by NBI magnifying endoscopy. Based on both pit appearance and microvessel features, lesions were classified into three grades (C1, C2, C3), as described previously. Also, lesions were classified as high or low by microvessel irregularity. Furthermore, the histopathological background and the inter- and intraobserver variability of C subtype were assessed. The SM-m rate of C1, C2 and C3 was 5.2, 60.5 and 92.7%, respectively. On the other hand, SM-m rate of lesion with mildly and highly irregular vessels was 13.3 and 55.0%, respectively. For the histopathological background, a high percentage of destruction of the glandular orifice, disappearance of the lamina muscularis mucosae and superficial exposure of desmoplastic reaction (DR) were observed in type C3. For C subtype classification of NBI magnification findings, the kappa value for interobserver variability was 0.749, and the kappa value for intraobserver variability was 0.745. NBI magnification findings evaluated by both pit appearances and microvessel features (C subtype) showing a good kappa value in variability are more useful in invasion depth diagnosis of colorectal tumor than those evaluated by microvessel features alone.


Transient changes in cytokine profiles following ivermectin treatment of onchocerciasis.
Cytokine production by peripheral blood mononuclear cells after antigen or mitogen stimulation was assessed before and after semiannual ivermectin treatment of 27 patients with onchocerciasis. Before treatment, Onchocerca volvulus antigen (OvA) elicited interleukin (IL)-5 production but inhibited production of IL-10, granulocyte-macrophage colony-stimulating factor (GM-CSF), and tumor necrosis factor-alpha. Six months after the first dose of ivermectin, there were increases in the IL-2, IL-4, IL-5, and interferon-gamma responses to mitogen and in the GM-CSF and IL-10 responses to OvA. By 24 months (after four ivermectin doses), OvA-induced GM-CSF production and mitogen-induced IL-2 and IL-10 production remained elevated above pretreatment levels, whereas that of other cytokines returned to or below pretreatment levels. These transient changes in cytokine response profiles of patients with onchocerciasis following ivermectin treatment likely reflect changes in antigen load.


Successful ablation of a right atrium-axillary ventricular accessory pathway associated with Wolff-Parkinson-White syndrome.
We report a case of a patient with right axillary ventricular. Similar congenital anomaly of the right atrium was reported as "right appendage diverticulum or right atrial diverticulum." However, this independent chamber has its own annulus, synchronizes with the right ventricular, and generates large ventricular potential. Under the guidance of the CARTO mapping system (Biosense Webster, Diamond Bar, CA, USA), a right atrioventricular accessory pathway associated with type B Wolff-Parkinson-White syndrome was ablated successfully. This pathway was close to the annulus of the axillary ventricular. The patient remained free of arrhythmia at 1-year follow-up.


Ethical and legal considerations in a Swiss study on the quality of pharmacotherapy in the city of Basel.
We describe a study on the quality of pharmacotherapy that included downloading electronic records in pharmacies and obtaining other information from the Public Sickness Fund in Basel, Switzerland. Legal and ethical considerations were discussed with and approved by the Internal Review Board of the university clinics through which the project was organized. Technical procedures were used to assure anonymity of the records during data collection and for the analysis. Completion of the records through links with personal data could be performed using a legally required process for quality assurance of the Public Sickness Fund.


Low control-power wavelength conversion on a silicon chip.
We demonstrate controlled wavelength conversion on a silicon chip based on four-wave mixing Bragg scattering (FWM-BS). A total conversion efficiency of 5% is achieved with strongly unbalanced pumps and a controlling peak power of 55 mW, while the efficiency is over 15% when using less asymmetric pumps. The numerical simulation agrees with the experimental results. Both time domain and spectral domain noise measurements show as low as 2 dB signal-to-noise ratio (SNR) penalty because of the strong pump noise, two-photon absorption, and free-carrier absorption in silicon. We discuss how the scheme can be used to implement an all-optically controlled high-speed switch.


Unusual Behaviors of Electric-Field Control of Magnetism in Multiferroic Heterostructures via Multifactor Cooperation.
Electric-field control of magnetism (EFCM) is very important for the exploration of high-density, fast, and nonvolatile random-access memory with ultralow energy consumption. Here, we report the electric-field-induced ferroelectric phase transitions in Pb(Mg1/3Nb2/3)0.82Ti0.18O3 (PMN-0.18PT) and symmetry breaking of EFCM behaviors for corresponding directions in multiferroic heterostructures composed of amorphous ferromagnetic Co40Fe40B20 (CoFeB) and PMN-0.18PT. We uncover a new mechanism behind the unusual phenomena, involving coupling between CoFeB and PMN-0.18PT via complex cooperation of electric-field-induced ferroelectric phase transitions, competition of different ferroelectric domains, and internal electric field in PMN-0.18PT. The deterministic EFCM with reversible and nonvolatile nature opens up a new avenue for exploring EFCM in multiferroic heterostructures and is also significant for applications.


[Importance of social tuberculosis prophylaxis for the Armed Forces in present conditions].
Lately social prophylaxis of tuberculosis has taken on special significance in the Armed Forces of the Russian Federation. Thank to social measures of the modern military reform, such as reduction of conscription term, territorial principle of recruitment for the army, improvement of habitation, service and recreation conditions, improvement of quality and organization of a diet, improvement of quality of a uniform it succeeded in reducing tuberculosis morbidity in military servicemen from 2007 up to 2014 up to 65 percent. Nevertheless, the main ways of tuberculosis control in the army (military service prohibition for citizens with tuberculosis, early active case detection, prophylaxis in risk group, anti-epidemic measures in the army nidus of tuberculosis etc.) are still urgent. To increase an effectiveness of the work done it is necessary to specify procedure and period of preventive fluorography in military servicemen.


Mapping the regulon of Vibrio cholerae ferric uptake regulator expands its known network of gene regulation.
ChIP coupled with next-generation sequencing (ChIP-seq) has revolutionized whole-genome mapping of DNA-binding protein sites. Although ChIP-seq rapidly gained support in eukaryotic systems, it remains underused in the mapping of bacterial transcriptional regulator-binding sites. Using the virulence-required iron-responsive ferric uptake regulator (Fur), we report a simple, broadly applicable ChIP-seq method in the pathogen Vibrio cholerae. Combining our ChIP-seq results with available microarray data, we clarify direct and indirect Fur regulation of known iron-responsive genes. We validate a subset of Fur-binding sites in vivo and show a common motif present in all Fur ChIP-seq peaks that has enhanced binding affinity for purified V. cholerae Fur. Further analysis shows that V. cholerae Fur directly regulates several additional genes associated with Fur-binding sites, expanding the role of this transcription factor into the regulation of ribosome formation, additional transport functions, and unique sRNAs.


Risk Factors for Falls in People With a Lower Limb Amputation: A Systematic Review.
To review the evidence connecting risk factors to falls in adults with a lower limb amputation (LLA) across the continuum of care settings. Systematic review. Electronic database searches were conducted in MEDLINE, Pubmed, CINAHL, and EMBASE covering January 1988 to January 2016. Noninterventional studies, including cohort and cross-sectional studies, were included. Two reviewers independently completed data extraction and quality evaluation. Twelve studies met the inclusion criteria and quality of reporting was evaluated using the criteria by Tooth et al. The average quality of reporting score was 19.8, scores ranged from 16 to 29. Studies covered the acute hospital stay after the amputation, inpatient rehabilitation, and community living. Falls were a common occurrence, with the cohort studies reporting 20.8% for acute hospital stay to 58% in the community years after the amputation. Injurious falls also were common, with an occurrence ranging from 40% to 60%. Risk factors that increase falls and are shared with the general population of older adults include lower extremity muscle weakness, increasing age, comorbidities, and number of prescription medications. Risk factors for falls that are unique to adults with LLA are dysvascular etiology of the amputation, transtibial level of amputation in the postoperative period and transfemoral level postrehabilitation, and reduced sense of vibration. Falls in adults with an LLA are common from the time of the amputation to years later living in the community. Risk factors vary across care settings after the amputation, which has implications for safety and fall-prevention strategies. III.


Cell death in the thymus--it' s all a matter of contacts.
Apoptosis, or programmed cell death, plays a critical role in shaping the T cell repertoire, deleting unproductive as well as potentially autoreactive T cells. Our understanding of how thymocyte apoptosis is regulated is continually evolving, as new essential modulators of this process are discovered. A conundrum that remains, however, is how signaling through essentially the same receptors and cascades evokes distinct biological responses: death by neglect, positive or negative selection. We hypothesize that the immunological synapse (IS) may be critical to transducing survival signals during thymocyte development, and suggest that factors affecting IS assembly may also influence T cell selection.


Mothers' perspectives on qualities of care in their relationships with health care professionals: the influence of relational and communicative competencies.
Research suggests that parents of seriously ill children place significant value on the relational context of their children's health care. This psychological phenomenological study explored mothers' perspectives on qualities that they found to be either helpful or unhelpful to their experiences of caregiving. Relational and communicative competencies were identified as most influential in mothers' assessments of provider care. Practitioners experienced in end-of-life care were viewed as highly supportive by the mothers in the study. Training for professionals in principles of palliative and end-of-life care is recommended for those who work with these children and families.


A Hydroxamic Acid Anchoring Group for Durable Dye-Sensitized Solar Cells Incorporating a Cobalt Redox Shuttle.
A hydroxamic acid group has been employed for the first time as an anchoring group for cobalt-based dye-sensitized solar cells (DSSCs). The porphyrin dye YD2-o-C8HA including a hydroxamic acid anchoring group exhibited a power conversion efficiency (η) of 6.4 %, which is close to that of YD2-o-C8, a representative porphyrin dye incorporating a conventional carboxylic acid. More importantly, YD2-o-C8HA was found to be superior to YD2-o-C8 in terms of both binding ability to TiO2 and durability of cobalt-based DSSCs. Notably, YD2-o-C8HA photocells revealed a higher η-value (4.1 %) than YD2-o-C8 (2.8 %) after 500 h illumination. These results suggest that the hydroxamic acid can be used for DSSCs with other transition-metal-based redox shuttle to ensure high cell durability as well as excellent photovoltaic performance.


Endocardial mapping in humans in sinus rhythm with normal left ventricles: activation patterns and characteristics of electrograms.
Endocardial catheter mapping was performed in 15 patients in sinus rhythm who had no evidence of structural heart disease and normal left ventricles. Mapping was performed with the use of 10 mm interelectrode distance from various left ventricular endocardial sites. In 10 patients a quantitative analysis of electrographic amplitude, duration, and amplitude/duration ratio was performed. The normal left ventricular bipolar electrograms had an amplitude of greater than 3 mV, a duration of less than 70 msec, and an amplitude/duration ratio of greater than 0.045. Local activation times were also assessed in the 15 patients. This analysis revealed two endocardial breakthrough sites, one on the midinferior septum and a second on the anterior wall near the insertion of the anterior papillary muscle. We therefore have defined normal quantitative characteristics of left ventricular bipolar electrograms and the normal left ventricular activation sequence in the intact normal human left ventricle.


[The inhibitory effect of disodium cromoglycate on substance P sensory nerve fibres].
Electrical field stimulation of sensitized guinea pig hilus bronchi induced a long lasting contractile response which was insensitive to atropine, but could be antagonized by a substance P (SP) antagonist. Antigen challenge of sensitized guinea pig main and hilus bronchi evoked a double-phase contractile response which consisted of a rapid contraction and a slow contraction. Both of them were sensitive to SP-antagonist, especially its slow contraction. Disodium cromoglycate (DSCG) inhibited the contractile responses induced by electrical field stimulation and antigen challenge. significantly. These results suggest that DSCG has inhibitory effect on the release of SP sensory nerve fibre endings induced by some stimulators, which might be related to the effect of DSCG against asthma.


Effect of cigarette smoking on coronary patency after thrombolytic therapy for myocardial infarction. TEAM-2 Investigators. Second Multicenter Thrombolytic Trials of Eminase in Acute Myocardial Infarction.
Smokers have been reported to have an improved short-term prognosis after myocardial infarction when compared with nonsmokers. This study examines the effect of smoking status on infarct-related artery patency, a determinant of outcome, following thrombolytic therapy for acute myocardial infarction (AMI). To evaluate patency outcome by smoking status, the database of the Second Thrombolytic Trial of Eminase in Acute Myocardial Infarction was reviewed, and baseline characteristics were compared with infarct-related artery patency early (90 to 240 minutes) after thrombolysis in smokers versus nonsmokers. Smokers were younger (mean age 53 vs 59 years, p = 0.0001), more likely to be men (86 vs 73%, p = 0.008), normotensive (74 vs 58%, p = 0.004), to have an inferior infarction (66 vs 51%, p = 0.007), and tended to have higher hematocrits and fibrinogen levels than nonsmokers. Smokers had a significantly greater chance of achieving complete perfusion (Thrombolysis in Myocardial Infarction trial grade 3) (66 vs 51% p = 0.007) than nonsmokers, although the combination of grades 2 and 3 did not differ. After correcting for imbalances in baseline and angiographic variables, multivariate logistic regression identified smoking (odds ratio 1.8, p = 0.01) and infarct location (odds ratio 1.7, p = 0.03) as independent predictors of achieving grade 3 flow. The independent predictive component of smoking for achieving grade 3 patency after thrombolysis suggests the hypothesis that more active thrombogenic mechanisms may be operative in smokers, leading to a larger thrombus component that is more susceptible to lytic therapy.


A SPECIATIONAL HISTORY OF "LIVING FOSSILS": MOLECULAR EVOLUTIONARY PATTERNS IN HORSESHOE CRABS.
Horseshoe crabs' exceptional morphological conservatism over the past 150 My has led to their reputation as "living fossils," but also has served to obscure phylogenetic relationships within the complex. Here we employ nucleotide sequences from two mitochondrial genes to assess molecular evolutionary rates and patterns among all extant horseshoe crab species. The American species Limulus polyphemus proved to be the sister taxon to a clade composed of the Asiatic species Tachypleus gigas, T. tridentatus, and Carcinoscorpius rotundicauda, whose relationships inter se were not resolved definitively. Both absolute and relative rate tests suggest a moderate slowdown in sequence evolution in horseshoe crabs. Nonetheless, dates of the lineage separations remain uncertain primarily because of reservations about molecular-clock calibrations resulting from large rate variances at examined loci across Arthropods and other animal lineages, as inferred in this and prior studies. Thus, ironically, separation dates as estimated by molecular evidence in general may remain most insecure in taxonomic groups for which such information is needed most-those lacking strong biogeographic or fossil benchmarks for internal-clock calibrations. In any event, the current results show that large numbers of molecular characters distinguish even these most morphologically conservative of organisms. Furthermore, comparisons against previously published mitochondrial sequence data in the morphologically dynamic hermit crab-king crab complex demonstrates that striking heterogeneity in levels of morphotypic differentiation can characterize Arthropod lineages at similar magnitudes of molecular divergence.


Relationship between coronary artery and descending thoracic aortic calcification as detected by computed tomography: the Multi-Ethnic Study of Atherosclerosis.
Cardiac computed tomography (CT) is a well-established tool for the detection of cardiovascular calcium. Coronary artery calcification (CAC) is highly sensitive for the detection of coronary artery disease (CAD) as well as predictive of future cardiovascular (CV) events. Descending thoracic aortic calcification (DTAC) is common in the elderly and its presence is also associated with increased risk of CV events. Previous studies demonstrate that DTAC is associated with obstructive CAD and coronary risk factors. However, no prior studies have examined the association of CAC and DTAC as detected by cardiac CT in a large population-based cohort. In the Multi-Ethnic Study of Atherosclerosis, the study population included a population-based sample of four ethnic groups (Chinese, White, Hispanic and African-American) of 6814 women and men ages 45-84 years old. Participants underwent non-enhanced cardiac CT and both CAC and DTAC were quantified. DTAC was measured from the lower edge of the pulmonary artery bifurcation to the cardiac apex. Multivariable relative risk regression was used to evaluate relationships between CAC, DTAC and measured cardiovascular risk factors. Overall 3030 (44%) did not demonstrate any detectable CAC or DTAC. A total of 1930 (28%) had only CAC, 386 (6%) had isolated DTAC, and 1464 (22%) participants were found to have both CAC and DTAC. CAC had a higher prevalence than DTAC in men (58% vs. 45%). Participants with DTAC were older than those with CAC (mean age was 71 and 66 years old, respectively). Participants with DTAC had increased risk for the presence of CAC independent of cardiovascular risk factors (prevalence ratio [PR]: 1.17, 95% CI: 1.07-1.28). Severity of DTAC was a stronger predictor of the presence of CAC in women as compared to men (PR: 1.04, 95% CI: 1.02-1.06, and PR: 0.99, 95% CI: 0.98-1.01, respectively). DTAC was found to be a strong predictor of CAC independent of CV risk factors. Ongoing follow-up of this cohort will evaluate whether DTAC is an independent marker of risk for CV events.


Anterior urethral valves: not such a benign condition….
Anterior urethral valves (AUVs) is an unusual cause of congenital obstruction of the male urethra, being 15-30 times less common than posterior urethral valves (PUVs). It has been suggested that patients with congenital anterior urethral obstruction have a better prognosis than those with PUV, with less hydronephrosis, and a lower incidence of chronic renal insufficiency (5 vs. 30%). The long-term prognosis of AUVs is not clear in the literature. In this report we describe our experience and long-term follow up of patients with anterior urethral valve. We retrospectively identified 13 patients who presented with the diagnosis of AUVs in our institutions between January 1994 and June 2012. Two patients were excluded: one patient had no follow up after intervention; the other had a follow up <1 year. From the 11 patients included, we evaluated the gestational age, prenatal and postnatal ultrasound findings, voiding cystourethrogram findings, age upon valve ablation, micturition pattern, creatinine, and clinical follow up. Between 1994 and 2012 we evaluated 150 patients with the diagnosis of urethral valves. Of this group, 11 patients (7.3%) had AUVs and an adequate follow up. Mean follow up is 6.3 years (2.5-12 years). Five (45.4%) patients had prenatal diagnosis of AUV. The most common prenatal ultrasonographic finding was bilateral hydronephrosis and distended bladder. One patient showed a large perineal cystic mass, which was confirmed to be a dilated anterior urethra. The mean gestational age was 37.6 weeks (27-40 WGA). Postnatally, 90% had trabeculated bladder, 80% hydronephrosis, and 40% renal dysplasia. The most common clinical presentation was urinary tract infection in five patients (45.4%), followed by weak urinary stream found in four patients (36.3%). The age at initial surgical intervention ranged between 7 days and 13 years. Seven (63.6%) patients had primary transurethral valve resection or laser ablation and three patients (27.2%) had primary vesicostomies. One boy (9.1%) had penile urethrostomy with excision of urethral diverticulum. Two (18.2%) patients developed end-stage renal disease. Anterior urethral valve is a rare congenital entity affecting the genitourinary system in males. Early urinary tract obstruction resulted in end-stage renal disease in 18% of our patient population. In our series, the complication rate and the evolution to renal failure are high and similar to patients with PUV. In patients with AUVs we recommend long-term follow up and close evaluation of patient's bladder and renal function.


Economic growth and environmental pollution in Myanmar: an analysis of environmental Kuznets curve.
This empirical study examines the short- and long-run relationship between GDP as an economic growth indicator and CO2 emissions as an environmental pollution indicator in Myanmar by using annual time series data over the period of 1970-2014. It also carefully considered other proxies, such as trade openness, financial openness and urbanization, and structural breaks in the country. The fundamental objective of this study is to test the validity of environmental Kuznets curve (EKC) in the context of Myanmar. The dynamic estimates of the long- and short-term relationship among greenhouse gases (CO2, CH4, N2O), GDP, trade intensity, financial openness, and urbanization growth are built through an autoregressive distributed lag (ARDL) model. The empirical findings indicate that there is positive short- and long-run relationship between CO2 and GDP and thus, no evidence of EKC hypothesis is found for CO2 in Myanmar. Nevertheless, the existence of the EKC is observed for CH4 and N2O. On the other hand, trade and financial openness have inverse relationship with CO2 emissions. These results demonstrate that trade liberalization and financial openness will improve the environment quality in Myanmar in the long run.


Clinical utility of chosen factors in predicting post-stroke depression: a one year follow-up.
The aim of the study was to identify possible interrelation between the presence of post-stroke depression (PSD) and chosen clinical and demographic parameters. Initially 116 patients (61.4 ± 12.6 years, women N = 42) hospitalized in Neurology Department, Medical University of Gdańsk (April 2003 - December 2005) due to first ischemic stroke, were included in the study. We analysed demographic data, the lesion's side and location according to neuroimaging and global neurological deficit estimated on the first day after the stroke and at discharge using NIHSS (National Institutes of Health Stroke Scale) and Barthel Index of Activity of Daily Living. Psychiatric evaluation was done:6 (42 ± 3 days) and 12 weeks (84 ± 7 days), as well as 6 (±14 days) and 12 months (±14 days) after stroke based on ICD-10 and functional assessment scale (Rankin Scale). Depression was diagnosed in 29 patients (27.6%). No correlation was found between PSD and sex or age. On the first day and at discharge patients without PSD were functioning slightly better but the difference was not statistically significant. We found association between the presence of PSD and the results of Rankin scale with the exception of degree of improvement during whole observation. In the group of patients with PSD left hemisphere strokes were slightly more common, but the difference did not reach statistical significance. The location of lesions in frontal lobes and basal ganglia was associated with presence of depression. We found the association between the presence of PSD and location of lesions (frontal lobes or basal ganglia), as well as with the degree of functional improvement during 12 months after stroke.


Atomic absorption spectrophotometric determination of 4-hydroxy-3-nitrobenzenearsonic acid (roxarsone) in premixes.
Roxarsone (4-hydroxy-3-nitrobenzenearsonic acid) is extracted from the premix with aqueous 1% ammonium carbonate. The extract is filtered, diluted, and analyzed by atomic absorption spectrophotometry, using an air-acetylene flame and an arsenic electrodeless discharge lamp. The instrument response of the sample is compared to that of a standard solution of arsenic trioxide. Recoveries range from 99.7. to 100.4% and coefficients of variation range from 0.35 to 0.63%.


BET 2: Pre-hospital finger thoracostomy in patients with chest trauma.
A short cut review was carried out to see if 'finger' thoracostomy is a safe and effective method of treating a tension pneumothorax in a pre-hospital setting. Five relevant papers were found looking at this technique in the pre-hospital setting. The author, date and country of publication, patient group studied, study type, relevant outcomes, results study weaknesses of these papers are tabulated. This technique appears to be safe and effective when performed by trained physicians in a pre-hospital setting.


Clinical subsets of juvenile dermatomyositis classified by myositis-specific autoantibodies: Experience at a single center in Japan.
Objectives: This study investigated the association between myositis-specific autoantibodies (MSAs) and clinical subsets of juvenile dermatomyositis (JDM) in Japanese patients. Methods: Twenty-one patients at a single center who developed initial or relapsed JDM from 2011 to 2016 were analyzed. Serum concentrations of MSAs against TIF1-γ, MDA5, NXP2, Mi-2, ARS, and SAE were measured by enzyme-linked immunosorbent assays. Clinical symptoms and laboratory data were obtained from clinical records. Clinical characteristics were compared in patients with autoantibodies against TIF1-γ, MDA5, and NXP2. Results: Of the 21 patients, 20 (95.2%) were positive for one or more MSAs, including nine (42.9%), five (23.8%), six (28.6%), and one (4.8%) positive for anti-TIF1-γ, anti-MDA5, anti-NXP2, and anti-Mi-2 autoantibodies. No patient was positive for anti-ARS or anti-SAE autoantibodies. The frequency of diffuse cutaneous lesions was higher in patients with anti-TIF1-γ autoantibodies. Anti-MDA5 autoantibody-positive patients had features of interstitial lung disease on chest computed tomography. Severe muscle damage at disease onset was significantly associated with positivity for anti-NXP2 autoantibodies. Conclusion: Similar to findings in Western countries, the clinical characteristics of JDM in Japanese may differ for each type of MSAs.


Comparing ecological risks of pesticides: the utility of a Risk Quotient ranking approach across refinements of exposure.
Environmental risk assessment of pesticides and other chemicals often uses the Risk Quotient (RQ) method to characterize risk quantitatively. An RQ is calculated by dividing an environmental exposure value by a toxicity end-point value. Tier 1 RQs, which are characterized by highly conservative toxicity and exposure assumptions, are used primarily for screening out negligible risks in regulatory decision making. It has been argued that the tier 1 RQ approach is valuable for making direct comparisons of quantitative risk between pesticides. However, an outstanding question is whether relative risks among pesticides would change if refinements of exposure are incorporated into the RQ calculations. This study tested that hypothesis. Aquatic ecological risk assessments were conducted for 12 herbicide and 12 insecticide active ingredients used on agricultural crops in the USA. The pesticides were chosen because surface-water monitoring data for them were available as part of the United States Geological Survey's National Water-Quality Assessment Program (NAWQA). Ecological receptors and effects evaluated were aquatic non-vascular plants (acute risk), aquatic vertebrates (acute risk) and aquatic invertebrates (acute risk) for the herbicides and aquatic vertebrates (acute and chronic risk) and aquatic invertebrates (acute and chronic risk) for the insecticides. The data indicate that there were significant statistical correlations between numerical rankings of tier 1 RQs and RQs using refined environmental exposures. The results support the hypothesis that numerical ranking of RQs for the purpose of comparing potential ecological risks is a valid approach because the rankings are significantly correlated regardless of the degree of exposure refinement.


Determinants of job motivation among frontline employees at hospitals in Tehran.
Human resources are the most strategic resource and the most significant input for health systems. Their behavior and motivation can strongly affect the overall performance of the health systems. The aim of this study was to determine the factors that affect motivation in frontline employees at teaching hospitals affiliated with Shahid Beheshti University of Medical Sciences (SBMU) in Tehran, Iran. This cross-sectional study was conducted in 2015. The participants (nurses, physiotherapists, radiology and laboratory technicians, operating room and pharmacy staff) were 300 employees selected by the stratified random sampling method from two general and teaching hospitals. The data collection instrument was a questionnaire that consisted of 42 questions in the 7 domains of motivational factors. Data analysis was performed using descriptive statistics and independent samples t-test by SPSS software, version 23. The findings indicated that working relationships (mean of 3.95) were the main determinant of job motivation of frontline employees. Job content (3.76) career development (3.75), social respect (3.75), and autonomy (3.30) were the next four affective factors. Recognition and remuneration had the least influence on the job motivation of frontline employees. The results of the Friedman test indicated that the difference between the mean scores of different dimensions was significant (χ(2) (6) = 607.00, p < 0.001). A hospital that seeks to engender increased motivation of its frontline employees should have in place a human resources strategy that includes facilitating communication between personnel and management, supporting employees in the community, and promoting social respect for health professions, providing educational opportunities and career development, development of appropriate promotional policies, employee participation in goal setting, facilitating a good working environment and job security, job enrichment, and delegation.


Separation procedures applicable to lignan analysis.
Lignans are a class of secondary plant metabolites produced by oxidative dimerization of two phenylpropanoid units. They have been found in many plants of Oriental medicine. In consequence of recent knowledge it is held that lignans are responsible for the key pharmacological activities of these plants. This review surveys the chromatographic, electromigration and hyphenated methods so far applied for the separation of lignans in Oriental plants used in phytotherapy as well as for the analyses of these lignans and their metabolites in biological matrices and food samples. In addition, the sample clean-up procedures--solvent extractions and supercritical fluid extractions--are also included.


Acute inflammatory ankle arthritis in northern India--Löfgren's syndrome or Poncet's disease?
To analyse patients presenting with acute inflammatory ankle arthritis from an aetiological standpoint; whether they had Löfgren's syndrome (acute presentation of sarcoidosis), or Poncet's disease (reactive arthritis due to tuberculosis infection). An additional objective was to establish a simple, practical yet optimal algorithm for diagnostic approach and management of such patients. The study included 18 patients from northern India presenting with isolated acute inflammatory ankle arthritis. A combination of complete clinical evaluation, Mantoux test and contrast-enhanced computerised tomography (CE-CT) of the chest was carried out and results analysed. Among 18 patients presenting as inflammatory ankle arthritis is was possible to classify 10 of them as Löfgren's syndrome all of whom had negative Mantoux test and bilateral hilar lymphadenopathy without central necrosis. The other 8 patients could be classified as Poncet's disease as all of them had positive Mantoux test and showed mediastinal lymphadenopathy with or without unilateral hilar lymph nodes, with central necrosis. Finally, appropriate drug treatment (glucocorticoids with glucocorticoid-sparing drugs methotrexate and hydroxychloroquine in patients with Löfgren's syndrome; standard anti-tuberculosis drugs in Poncet's disease) gave excellent clinical response and patients remained well over a period of 1 year of follow-up. Investigated on standard lines without any invasive procedure, patients with isolated inflammatory ankle arthritis could be classified in 2 distinct categories namely: (1) Löfgren's syndrome in its complete (with EN) or incomplete (without EN) form; (2) Poncet's disease. Appropriate treatment gave satisfactory response and patients remained well over a period of 1 year of follow-up.